PMID: 9159600Apr 1, 1997Paper

Secondary prevention of heart disease amongst patients with lipid abnormalities: practice and trends in the United States

Journal of Internal Medicine
B G BrownJ J Albers

Abstract

Patients with established coronary disease and abnormalities of lipid metabolism represent a particularly important subgroup, since their mortality risk is typically 10 times greater than that amongst-subjects with comparable risk factors but no clinical history. Such patients are commonly treated initially with anti-anginal therapy; if ischaemic symptoms persist they often undergo revascularization (bypass or angioplasty). While invasive procedures restore blood flow and relieve ischemia, they do not, in most cases, reduce risk of subsequent MI or death, or alter the underlying atherogenic process(es). Despite this, there has been a progressive 54% decline in age-adjusted cardiac mortality over the period 1960-1995, which appears best attributable to US lifestyle changes. In particular, the past decade has provided compelling evidence for the merits of a fourth approach: comprehensive risk factor management. Clinical outcome studies have confirmed the substantial merit of aspirin prophyllaxis and of intensive lipid-lowering therapy in secondary prevention. Prospective angiographic trials and evidence from studies of vascular biology have provided insight into mechanisms of benefit. As a consequence, lipid therapy and aspirin u...Continue Reading

Citations

Oct 28, 1998·Progress in Cardiovascular Diseases·L M Belalcazar, C M Ballantyne
Feb 6, 2002·Preventive Cardiology·C M Ballantyne, G R Rangaraj
Mar 4, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Alan B Lumsden, Terry W Rice
Jan 13, 2000·Journal of General Internal Medicine·S R MajumdarS B Soumerai
Aug 26, 2003·Mayo Clinic Proceedings·Michael Miller
Jan 14, 2005·Journal of the American Academy of Nurse Practitioners·Kathy Berra
Nov 18, 1998·The American Journal of Cardiology·C M Ballantyne
Oct 24, 1998·Endocrinology and Metabolism Clinics of North America·S M Grundy
Jul 31, 1998·The American Journal of Medicine·C M Ballantyne
Apr 7, 1999·Current Opinion in Cardiology·C E Cannon, S C Smith
Mar 21, 1998·Current Opinion in Lipidology·F W Hanna
May 28, 2021·Pediatric Obesity·Dani O Gonzalez, Marc P Michalsky
Dec 7, 2002·The American Journal of Cardiology·Antonios M Xydakis, Christie M Ballantyne

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